Temporal Analysis and Remote Monitoring of ECG Signal

Temporal Analysis and Remote Monitoring of ECG Signal Amruta Mhatre Assistant Professor, EXTC Dept. Fr.C.R.I.T. Vashi Amruta.pabarekar@gmail.com Sadhana Pai Associate Professor, EXTC Dept. Fr.C.R.I.T. Vashi sadhanapai@rediffmail.com Abstract The system Temporal analysis and remote monitoring of ECG signal is developed to assist patients and doctors in health care. An arrhythmia is an abnormal heart rhythm. It can cause the heart rate to be too slow or too fast. Enough blood is not provided by the heart to the body when arrhythmias are severe or last long enough. This can cause patient to feel tired, lightheaded or may make him pass out. It can also cause death. Before treatment, it s important for the doctor to know where an arrhythmia starts in the heart and whether it s abnormal. An electrocardiogram (ECG) is often used to diagnose arrhythmias. Temporal analysis and remote monitoring of ECG signal is meant to acquire ECG signal from patient and analyze it to detect and classify its anomalies and abnormalities. This is achieved by extracting amplitudes and durations of parameters of ECG waveform such as P wave, QRS complex, RR interval and PR durations. These parameters are compared with the normal values to determine the type of abnormality. Database of the patient is maintained for further use by the doctor. Under critical conditions, transmission scheme will ensure successful transmission of critical messages to doctors via Global system for mobile (GSM) network. Keywords: ECG, arrhythmia, GSM. I. INTRODUCTION Many developing countries suffer from an acute shortage of medical professionals, particularly specialists. India is one of the many countries facing severe shortages of trained medical professionals. One doctor has to serve many hospitals and hence they are not available full time in a single hospital. The available specialists and services are concentrated in big cities, while workers in rural health care, who serve most of the population, are almost completely isolated from specialist services. These patients have to travel long distances in order to be seen by a specialist cardiologist [1-2]. The ECG waveform that reflects the electrical activity of the heart, is widely used as a routine cardiac diagnostic tool. In conventional methods of ECG diagnosis, physician tries to find whether the ECG signal is different from normal sinus rhythm in terms of the morphology of each component, time intervals and heart rate [3-4]. Heart attack is usually considered as major heart disease but there are many other problems that compromise heart functions such as coronary artery disease, heart failure and arrhythmias. An arrhythmia is an abnormal heart rhythm. Some of the arrhythmias such as ventricular tachycardia and ventricular fibrillation are associated with sudden cardiac death. If arrhythmias persist in a patient, then medical care should be taken as early as possible in order to save patient s life. In the United States, each year more than 850,000 people are hospitalized for an arrhythmia [5]. II. THE ANALYSIS OF ELECTROCARDIOGRAM (ECG) The normal ECG is composed of a P wave, a QRS complex and a T wave. The P wave and the QRS represent atrial and ventricular depolarization respectively. The T wave reflects the phase of rapid repolarization of the ventricles [1]. Fig.1. Typical representation of the ECG wave [8] The P wave represents the spread of electrical impulse through the atrial musculature that is activation or depolarization. The PR interval reflects the time taken by the impulse to travel the entire distance from the SA Node to the ventricular muscle fibers. It represents the spread of the electrical impulse through the ventricular muscle that is 978-1-4799-7263-0/15/$31.00 2015 IEEE

depolarization. The S-T segment follows the QRS complex. The T wave represents the period of recovery for the ventricles [2]. Table 1.ECG reference model for a normal man [9]. Parameter Reference Value Heart Rate 60-100 beats per minute (BPM) P wave Duration < 0.12 s; Amplitude < 0.25mV preprocesses it. The amplified and filtered ECG signal is analyzed using LabVIEW software and results are stored in the form of report. An informative SMS is sent to the doctor s mobile under the abnormal condition via GSM modem SIM- 900. A. ECG signal analysis Flowchart for ECG signal analysis is as shown in figure 3. P-R interval QRS complex Q-T interval Duration 0.12-0.20 s Duration 0.04 0.12s; Amplitude 0.5 1mV Duration 0.39-0.42 s An arrhythmia is an abnormal rate and/or rhythm of the heartbeat. It arises when the electrical impulses to the heart that coordinate heartbeats are not working properly, making the heart beat too fast/slow or inconsistently. [7][9]. Arrhythmias may occur because of the following reasons, Sinus node is not able to generate enough heartbeats. Abnormal rhythm of sinus node. Fig 3. Flowchart of ECG analysis The heart rate is calculated as follows, Heart rate =(1/RR interval in sec.)*60. Analyais based on heart rate is explained with the help of flowchart as follows. Other area in the atria take over the function of the sinus node. Abnormally fast heart rate is called as Tachycardia and abnormally slow heart rate is called as Bradycardia. In Bradycardia, the heart rate is too slow that is less than 60 beats per minute. Whereas in Tachycardia, the heart rate is too fast that is more than 100 beats per minute. When the electrical signal is slowed or disrupted as it moves through the heart, it is considered as a Heart block. Heart block is also a type of arrhythmia. A first degree AV node block occurs when conduction through the AV node is slowed. A first degree AV block is indicated on the ECG by a prolonged PR interval. First-degree heart block is not very severe [5]. III. SYSTEM DESCRIPTION The block diagram of the system is as shown in figure 2. Fig 2. System Block Diagram It consists of ECG extraction circuit which extracts the ECG signal of the patient using Ag-AgCl electrodes and B. LabVIEW code Fig 4. Analysis based on ECG Acquired Sound VI is used to acquire ECG signal through audio port with the sampling rate of 11025 Hz. The acquired ECG signal has dynamic data type since it is acquired via sound port. The LabVIEW ASPT provides the WA Detrend VI converts the acquired ECG signal in waveform format and also removes the trend from the signal and make it suitable for further analysis. Wavelet transform level = floor (log 2 [ ])

Heart Rate (BPM) QRS Interval (Sec) Fig 5. Code for Preprocessing of ECG Signal The LabVIEW code for calculating heart rate is as shown in figure 6. PR interval (Sec) Fig 7. Decision Logic for identification of diseases RESULTS AND CONCLUSION Fig 6. VI for Calculating Heart Rate The ECG signal has been acquired from a person using the designed circuit through Ag-AgCl electrodes and it has been displayed on DSO which has heart rate of 80 bpm and amplitude of 1.1V as shown in figure 8. In order to communicate via serial port for sending SMS PL2303 prolific device driver has been installed. Port has been configured for baud rate 9600 bps with 1 stop bit. GPRS Execute Command VI with VISA VIs has been used in LabVIEW for communicating with GSM modem SIM 900 via serial port. C. Decision Logic for identification of disease The heart rate, PR interval and QRS interval are compared with their normal range. The normal heart rate lies in the range of 60 to 100 beats/minute. PR interval and QRS interval lies in the range 0.12-0.2 sec and 0.04-0.12 sec respectively. When heart rate is beyond 100 beats/minute with normal PR interval and QRS interval, it is considered as Sinus Tachycardia. When heart rate is below 60 beats/minute with normal PR interval and QRS interval, it is considered as Sinus Bradycardia. When PR interval is more than 0.2 sec with normal heart rate and QRS interval, it is considered as first degree AV block. Fig 8. Acquired ECG signal on DSO The acquired ECG signal from a person using the designed circuit and its LabVIEW analysis is as shown in figure 9.

In this way the observed values for PR interval and QRS interval have been noted for other abnormalities like Bradycardia, Tachycardia and 1 st degree AV Block. The analysis results and observed readings for the ECG signal have been noted and tabulated as shown in the table 2. Table 2 Measured and Observed values of ECG parameters Fig. 9. ECG analysis results using LabVIEW The analysis results has been verified with the observed values as follows. Figure 10 shows cursor positions for observing PR interval. The observed value of PR interval is 2.03225-1.87096 = 0.161 sec. ECG signal analysis has been done with LabVIEW software with input collected from ECG simulator then filtered and amplified using designed circuit and the analysis report also been generated using LabVIEW as shown in figure 12. Fig. 10. Observed value of PR interval with a person as a subject Figure 11 shows cursor positions of observing QRS interval. The observed value of QRS interval is 2.1-2.02580=0.0742 sec. Fig. 11. Observed value of QRS interval with a person as a subject Fig 12. Generated Report using LabVIEW

The enitire set up was tested for abnormal conditions. When the heart rate went beyond its range of 60-100 BPM, the following message was transmitted by the system via SMS. Figure 13 shows the SMS received for abnormal ECG signal of heart rate 120 BPM Fig. 13. SMS received for abnormal ECG signal Temporal Analysis and Remote Monitoring of ECG signal is a smart measurement system for monitoring ECG signal. The system acquires ECG signal from patient and analyses the real time signal for the further detection of arrhythmia. In case of an emergency the system connects to the GSM service to transmit patient s data and rough estimate of the type of disease to the doctor s mobile. This system can have a widespread application in developing countries where the doctor to patient ratio is very less and where people cannot afford to travel long distance for continuous monitoring of health. REFERENCE [1] M. K. Islam, A. N. M. M. Haque, G. Tangim, T. Ahammad, and M. R. H. Khondokar, Member, IACSIT, Study and Analysis of ECG Signal Using MATLAB & LABVIEW as Effective Tools, International Journal of Computer and Electrical Engineering, Vol. 4, No. 3, June 2012. [2] John A Kastor, Cardiac Arrhythmias, University of Maryland, Baltimore, Maryland, USA. [3] [ONLINE] http://www.medicinenet.com. [4] Understanding Arrhythmias, by Boston scientific corporation, 2005, EPT-10470_01/06. [5] M.G. Tsipouras, D.I. Fotiadis, D. Sideris, An arrhythmia classification system based on the RR-interval signal, Artificial Intelligence in Medicine 33, 237 250, 2005. [6] Elizabeth M. Cherry and Flavio H. Fenton, Heart Structure, Function and Arrhythmias, Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University. http://thevirtualheart.org. [7] Thakor NV, Natarajan A, Tomaselli G., Multiway sequential hypothesis testing for tachyarrhythmia discrimination, IEEE Trans Biomed Eng 1994; 41:480 7. [8] Tatiparti Padma, M. Madhavi Latha, Abrar Ahmed, ECG compression and labview implementation, J. Biomedical Science and Engineering, 2009, 2, 177-183. [9] Zhang XS, Zhu YS, Thakor NV, Wang ZZ, Detecting ventricular tachycardia and fibrillation by complexity measure, IEEE Trans Biomed Eng 1999; 45:548 55.